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hospitals

Road to prosperity: five ways Mongolia can improve the quality of its infrastructure spending

Zahid Hasnain's picture

Financed by the mining boom, government spending on new infrastructure in Mongolia has increased 35-fold in the past 10 years. But you would not know this from driving the pot holed streets of Ulaanbaatar or inhaling the smog filled air of the city, particularly in the ger areas.

A new World Bank report I co-authored examines why this increased spending is not resulting in equivalent benefits for the citizens of Mongolia in terms of better roads, efficient and clean heating, and improved water and sanitation services.

Reforming hospitals in East Asia — engagement by development partners wanted

Toomas Palu's picture

Health systems are under pressure in Asia. Epidemiological and demographic transitions are taking place much faster than in Europe and America, in the span of a single generation. With the transition comes the non-communicable disease (NCD) epidemic that requires more sophisticated and expensive interventions provided by hospitals, inpatient or outpatient. Rapid economic development in Asia has lifted millions out of poverty and raised peoples’ expectations for services. Between China, India, Thailand, Philippines, Indonesia and Vietnam, expansion of health insurance coverage during the last decade has reached an additional one billion people, making services more affordable and thus increasing demand. Advancing medical technology eagerly awaited by specialist doctors sitting on top of health professional hierarchies further expands possibilities for treatment. The middle class votes with their feet and takes their health problems to medical tourism meccas like those in Bangkok and Singapore, voiding their own countries of additional income to health care providers. Policymakers are scrambling to expand hospital capacity, boost the pay of health professionals, and encourage investment to meet the demand.   

But governments do not wait. They are exploring hospital autonomy, decentralization, user fees and private sector participation. These policies often pose risks that need to be mitigated by policies and institutional arrangements. For example, health care providers sometimes order unnecessary procedures to earn additional revenue, thanks to the powerful incentive of the fee-for-service payment mechanism and information asymmetry between the patient and health care provider. This can mean financial ruin for both the patient and new, relatively weak health insurance agencies.

Despite these challenges, hospitals aren’t high on the international health development agenda, save a few initiatives to improve quality and provider payment reform.

From Kerema to Port Moresby: the raincallers and the road

Aleta Moriarty's picture

Roads are not sexy. You don’t see glossy ads pleading for people to sponsor a road. You don’t see the construction of a road moving global audiences to tears. There are no celebrities, concerts, wrist-bands for the road. I guess that is because for most people in the developed world, we take roads for granted.

Recently I spent some time around Kerema, which although only 350 km from the country’s capital, feels as one of the most remote and cut-off places in Papua New Guinea. Kerema is the Gulf’s provincial capital and, with its surrounding villages, it has been cut-off from the rest of the country due to a mere 67 km of mostly un-passable road. Under the Roads Maintenance and Rehabilitation Project, the World Bank has been supporting the Government of Papua New Guinea to restore the road. Today, the Bank’s Board of Executive Directors approved the second phase of this project, which will see the rest of the road restored and paved to a proper national standard.

Bouncing Babies and Safe Motherhood in Sri Lanka

Chulie De Silva's picture
Photo Credit: (c) Chulie De Silva

Reading the story today of Sri Lanka’s emergence as a success story in safer childbirth with a remarkable decline in maternal deaths, I mused about how I took for granted that childbirth would be safe when I had my children way back in the early 70’s. It was joy unlimited as I breezed through pregnancies always under the stern but very caring eye of my GP, Dr. Navaratnam. The news today that Sri Lanka should be held as an example for other South Asian countries makes me very grateful for the high quality of medical care that was available to us.

Presenting a paper at the Royal College of Obstetricians and Gynecologists, UK, South Asia Day, Dr Hemantha Senanayake, from the University of Colombo, said the “mortality ratio of Sri Lanka has declined dramatically as a direct result of the availability of midwives and trained assistance. “In 1960, the child mortality was 340 per 100,000; however, it was lowered to 43 per 100,000 live births in 2005.”